The nutritional treatment of depression

Hippocrates, the great Greek physician and Father of Medicine, said: “From the brain, and from the brain only, arise our pleasures, joys, laughter and jests, as well as sorrows, pains, griefs and tears.” It’s startling to learn that there are 15 trillion neurons (nerve cells) in the human brain. There are far more glial cells that fill the spaces between the neurons, Schwann cells and miles of blood vessels to nourish the three or so pounds of brain tissue in the average head.

Three pounds isn’t much: only 2% of the body weight of a person weighing 150 pounds. Brain cells are hungry cells, demanding nourishment from as much as 30% of the circulating blood. The brain is a chemical factory that produces neurotransmitters, natural chemicals that facilitate communication between nerve cells. To do this job, the brain needs raw materials in the form of amino acids, vitamins, minerals and other nutrients, which act as essential cofactors for enzyme catalysts.

Biochemical data on more than 3,000 (2003) persons diagnosed with clinical depression, allowed scientists at the Pfeiffer Treatment Centre in Illinois, USA to fit 95% of them into 5 separate biochemical classifications with completely different nutritional needs. Most persons with depression exhibit a genetic abnormality in methylation, which appears to be central to their illness. Methylation is a process where one molecule passes a methyl group to another molecule. This transaction is essential to more than hundred processes, from the brain to the bones, and is a major factor in the ratelimiting step in the synthesis of the neurotransmitters serotonin and noradrenaline in the brain.

Undermethylated persons tend to be depleted in the neurotransmitters serotonin and noradrenalin, while the opposite is true for overmethylation. The Pfeiffer Centre Programme is based on the work of Dr Carl Pfeiffer, an American psychiatrist and pioneer in orthomolecular psychiatry. This programme involves asking a basic question that few other practitioners ask: who is the patient nutritionally? Finding the answer involves extensive chemical analysis of blood, urine and hair to define the patient’s biochemistry. Treatment requires supplements of specific vitamins, minerals and amino acids, that need to be supplied with rifle-shot precision – and sometimes very high doses.

Nutrients and neurotransmitter balance
Tyrosine and 5-hydroxytryptophan (5-HTP) The neurotransmitters most closely associated with depression are serotonin and noradrenaline. Ground-breaking research by Professor Tapan Audhya from the New York Medical Centre, has made the measurement of a person’s serotonin and noradrenaline levels in platelets – tiny disc-like bodies in the blood – possible. ( T. Audhya 2005. Clin. Chem.; 51-6) His research shows that the levels of these neurotransmitters in platelets correlate with the levels in the brain. He found that 82% of depressed patients had only a third of the amount of noradrenaline, while 73% of depressed patients had barely a fifth the levels of serotonin compared to people without depression. He also showed that giving the right combination of nutrients, especially the protein constituents tyrosine, from which noradrenaline is made, and 5-HTP from which serotonin is made, resulted in significant and rapid relief from depression. 5-HTP dosage is 50-100 mg taken twice a day on an empty stomach. Do not combine with prescription antidepressants.

B vitamins: Vitamin B6, and vitamin B3, together with zinc, is required for the synthesis of serotonin. A deficiency of vitamin B12 is associated with depression. (Nutr. Rev. 1996; 54) Clinical studies have shown an inverse relationship between folate status and depression. Previous research has shown “enhanced antidepressant response with folic acid supplementation”(Bjelland et al. 2003 Arch. Gen. Psychiatry; 60), while people with a certain gene that alters folate metabolism and leads to a relative folate deficiency , are much more likely to suffer from depression.

Homocysteine: Homocysteine is a toxic amino acid made from dietary protein. High levels in the blood indicate undermethylation. A Norwegian study, involving nearly 6,000 patients, found that participants with the highest homocysteine levels were nearly twice as likely to be depressed, as those with the lowest levels. Blood homocysteine level is easily measured, and should ideally not be higher than your age divided by 10. Homocysteine levels can be lowered by eating foods rich in vitamins B2, B6, B12, folate and zinc, or taking a supplement containing these nutrients.

Essential fatty acids: Research has found that deficiencies in essential fatty acids, particularly the omega-3 type, lead to an increase in depression. (Bruinsma et al 2000 Nutr. Rev. 58) Some depressed people may have an impaired ability to metabolise certain essential fatty acids, leading to lower blood levels of omega-3s. (Prostagl. Leukotr. Essent. Fatty Acids 1999;60) Research (2007) at the Psychiatry Department of the University of Pittsburg shows that study participants who had high levels of long-chain omega-3 fatty acid intake, had higher volumes of grey matter in areas of the brain associated with emotional arousal and regulation.

Studies also show that omega-3 supplementation, is not only beneficial against depressive disorders, but may enhance the effects of prescription drugs for conditions such as depression. High and low-fat diets alter the ratio of omega-6 to omega-3 essential fatty acids in the body, resulting in increased levels of depression. Many people on on long-term very low-fat diets are notably irritable and depressed. (Am. J. of Clin. Nutr. 1995;62)

Chromium: People with “atypical depression” have a craving for sweets or other carbohydrates, a tendency to gain weight, are tired for no obvious reason and tend to feel groggy much of the time. These people are sensitive and easily hurt.

The onset of depression is usually before the age of thirty. Chromium is a highly effective antidepressant for people with “atypical depression”.( McLeod et al .2003. Biol. Psychiatry; 55), and also helps to stabilise blood sugar. A dosage of 3 to 5 mcg per body weight of chromium picolinate is recommended, taken in divided doses before breakfast and lunch.

Postpartum depression (PPD): Most women with PPD exhibit a copper overload and zinc deficiency. The cause appears to be genetic. Dr Walsh, Senior Scientist at the Pfeiffer Treatment Centre, found dramatic improvements after treatment with supplements that lower copper levels and restore normal copper to zinc ratios. (

Stress: Long-term stress increases cortisol levels, resulting in a serotonin-cortisol dysfunction which play a part in depression.

Hypoglycemia (low blood sugar): Glucose is the primary fuel for the brain. Low blood glucose levels are associated with tension, depression and other negative mood states. ( Taylor et al 1988. J. of Behav. Med.; 11) In one study 86% of people with hypoglycemia were depressed. A diet that promotes steady blood sugar levels, is one that consists of foods with a low glycemic index, the glycemic index being a way of ranking foods base on their overall effects on blood sugar levels. A diet with moderate levels of protein will lead to a steadier blood sugar level, as protein does not stimulate insulin release in the same way as carbohydrates.

Hypothyroidism, food allergies, Candia Albicans overgrowth, recreational and other drugs, caffeine and alcohol abuse as causes for depression, can be ruled out by a visit to a primary care physician The key to successful nutritional treatment of depression, is to determine a person’s biochemical individuality, and to provide focused appropriate supplementation . This, together with quality counseling and simple coping behaviours for managing stress, can bring lasting relief to most depressed people. Bibliography: www. New Optimum Nutrition for the Mind. Patrick Holford